Kim, Young-Jin;Cho, Hyun-Min;Yoon, Chee-Soon;Lee, Chan-Kyu;Lee, Tae-Yeon;Seok, June-Pill
Journal of Chest Surgery
/
v.44
no.2
/
pp.178-182
/
2011
Background: We analyzed the results of surgical reduction and fixation of ribs under thoracic epidural anesthesia and analgesia (TEA) in patients who had no more than 3 consecutive rib fractures with severe displacement to examine the clinical usefulness of this method. Materials and Methods: From May 2008 to March 2010, 35 patients underwent surgical reduction and fixation of ribs under TEA. We reviewed the indications for this technique, number of fixed ribs, combined surgical procedures for thoracic trauma, intraoperative cardiopulmonary events, postoperative complications, reestablishment of enteral nutrition, and ambulation. Results: The indications of TEA were malunion or nonunion of fractured ribs in 29 (82.9%; first operation) and incompletely ribs under previous general anesthesia in 6 (17.1%; second operation). The average number of fixed ribs per patient was 1.7 (range: 1~3). As a combined operation for thoracic trauma, 17 patients (48.6%) underwent removal of intrathoracic hematomas, and we performed repair of lung parenchyma (2), wedge resection of lung (1) for accompanying lung injury and pericardiostomy (1) for delayed hemopericardium. No patient had any intraoperative cardiopulmonary event nor did any need to switch to general anesthesia. We experienced 3 postoperative complications (8.6%): 2 extrapleural hematomas that spontaneously resolved without treatment and 1 wound infection treated with secondary closure of the wound. All patients reestablished oral feeding immediately after awakening and resumed walking ambulation the day after operation. Conclusion: Thoracic epidural anesthesia and analgesia (TEA) may positively affect cardiopulmonary function in the perioperative period. Moreover, this technique leads to an earlier return of gastrointestinal function and early ambulation without severe postoperative complications, resulting in a shortened hospital stay and lowered costs.
Kim, Sun-Joo;Choi, Hwan-Jun;Lee, Young-Man;Kim, Yong-Bae
Archives of Reconstructive Microsurgery
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v.18
no.1
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pp.27-30
/
2009
Purpose: Recently, replantation of fingertip amputation, Zone I by Yamano classification, is still difficult because digital arteries branch into small arteries and also digital veins are hard to separate from the immobile soft tissue. However the replantation of fingertip in adults is a well-established procedure, but the replantation in infant or child is still uncommon. Therefore we present one case of replantation of the fingertip of the small finger in 12-months-old patient. Methods: We experienced a 12-months-old male amputation of small finger. It had been amputated completely at the level of Zone I by Yamano classification. Replantation was performed using the arteryonly technique with neither vein nor nerve repair. Because the artery has been damaged, it is still possible to make a direct suture by transposing the arterial arch in an inverted Y to I arterial configuration. Venous drainage was provided by an external bleeding method with partial nail excision and repaired margin for approximately 7 days. Results: We were performed replantation in infant with only-arterial anastomosis successfully, result in good recovery of aesthetic and functional outcome. Conclusion: In conclusion, although fingertip injury was difficult to replantation in infant and child, we must try it. Because of its functional and cosmetic advantage.
Park, Jong-Ha;An, Soo-Hyeon;Kim, Jae-Gon;Baik, Byeong-Ju
Journal of the korean academy of Pediatric Dentistry
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v.24
no.4
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pp.805-812
/
1997
Despite dentistry's attempts to improve the dental health of the public and to minimize the effects of caries, many children still present with extensive destruction of primary anterior teeth. One of dentistry's most challenging tasks is to repair these teeth with restoration which are durable, retentive, and esthetic. Esthetic restoration can often be achieved with polycarbonate crowns, strip crowns, conventional S-S crowns, open-faced S-S crowns, commercially veneered S-S crowns. But, all of these have limitation. Advances in restorative materials and metal-bonding procedures have made possible new restorative techniques that combine the advantages of S-S crowns with the cosmetics of composite restoration methods. The described technique of bonding composite to trimmed and fitted S-S crowns offers many advantages over other techniques currently used to restore primary anterior teeth. 1. If S-S crowns are accurate trimmed and contoured, good retention of crowns is achieved. 2. The patient time required is similar to that of conventional S-S crowns. 3. Good esthetics and high bond strengths are achieved. 4. It is possible to use this veneering technique intraorally on crowns that have fractured veneers.
Though there might exist not a few differences between cyclic works and atypical works, many researchers have applied the same assessment techniques that used for repetitive works, which may result introduce bias in their conclusions. This research aimed to verify whether there exist non-negligible work characteristics and/or dissimilarity among works with different work nature and whether one of the most prevalent assessment techniques for assessing ergonomic hazards of musculoskeletal disorders, REBA, can be applied to atypical works. For a general hospital, an automobile repair shop, and two auto-part assembly plants which manufactures quite different parts, a questionnaire survey and field investigation and ergonomic assessment were carried out and analyzed statistically with reference to the 3rd Quantification technique. The results showed that there exist remarkable difference between physical factors in cyclic works and atypical non-cyclic works. As for repetitive work, body posture was significant factors affecting on musculoskeletal disorders while atypical works seemed to have none which implied that the necessity of taking psychosocial factors into account for assessment of hazards. Complain rate in repetitive works was highest shoulder, back, and neck or wrist in sequence. However, there existed no consistent trend in complain rate in atypical works. And, though weight of manufacturing objects was a common factor that can partly explain musculoskeletal complain, time duration was significant in atypical work whereas repeatability and body posture were significant in repetitive works. As being the results, to summarize, it could be said that application of conventional ergonomic assessment techniques regardless of repetitiveness would be fruitless, and that the necessity of a unique methodology focused on atypical non-cyclic works should not be neglected.
Journal of the Korea Academia-Industrial cooperation Society
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v.15
no.2
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pp.632-637
/
2014
In this paper the concept of the performance-based logistics (PBL) support for weapon systems is discussed and an enhancement is studied such that prior to the Operational phase, the development of the PBL can begin from the Engineering & Manufacturing Development (EMD) phase together with multiple performance indices considered. The genetic algorithm should be considered for the complex system to solve the maintenance policy optimization. In particular, the requirement of repair level analysis model is developed based on reflecting the PBL concept. To decide the maintenance policy prior to Operational phase in accordance with customer requirements, the PIDO(Process Integration and Design Optimization) technique useful in choosing the performance indices and changing the constraints was used. The genetic algorithm of PIDO tool, like PIAnO and ModelCenter, was verified that it could be applied to optimize the maintenance policy.
Purpose: Traumatic telecanthus can result from nasoethmoid-orbital fractures. Repair of the medial canthal tendon (MCT) using transnasal wiring is regarded as a choice of method to treat telecanthus, however, is often complicated by incomplete anchoring and drift of canthus, extrusion of wire, in-fracture of orbital bone, and eye damage. The authors introduced oblique transnasal wiring method through the Hiraga's epicanthopalsty incision instead of well-known classical bicoronal approach. Methods: Five patients with traumatic telecanthus were treated with this method. Though the Hiraga's epicanthoplasty incision, we could approach the operative field; the medial orbital wall and detached MCT. Oblique transnasal wiring was performed as following steps. After slit skin incision on the contralateral nasal recession area, drill holes were made from this point to the superior and posterior point of lacrimal sac of deformed eye. A 2-0 wire was double-passed through the holes and MCT. Traction was applied to ensure pulling the MCT and the wires were twisted in the contralateral nose, securing the MCT in the correct position. Results: All patients except 1 person showed improvement and rapid recovery. On average each canthus was moved 5.6 mm medially. In all cases, there were no eyelashes disappear, lacrimal canaliculitis, lacrimal duct injury, or infections. Conclusion: The Hiraga's epicanthoplasty incision could give sufficient operative field to reattach the MCT in traumatic telecanthus patients. And the oblique transnasal wiring technique is effective for the Asians who have flat nose and exophthalmic eye. The authors conclude that this technique could be a simple, safe and scarless method to correct traumatic telecanthus.
The uses of unmanned aerial vehicles (UAV) have been expanding in agriculture surveys, obtaining real time updates of dangerous facilities where human access is difficult, disaster monitoring, and 3D modeling. In reality, there is an upsurge in the application of UAVs in fields like, construction, infrastructure, imaging, surveying, surveillance and transportation. Especially, when the slope failure such as landslide occurs, the uses of UAVs are increasing. Since, the UAVs can fly in three dimensions, they are able to obtain spatial data in places where human access is nearly impossible. Despite of these advantages, however, the uses of UAVs are still limited during slope failure. In order to overcome these limitations, this study computes the soil volume change during slope failure through the computation technique using photogrammetric information obtained from UAV system. Through this study, it was found that photogrammetric information from UAV can be used to acquire information on amount of earthworks required for repair works when slope collapse occurs in mountainous areas, where human access in difficult.
Lee, Dongeun;Kim, Young Seok;Roh, Tai Suk;Yun, In Sik
Archives of Craniofacial Surgery
/
v.20
no.3
/
pp.170-175
/
2019
Background: Cryptotia is a congenital anomaly in which the upper part of the retroauricular sulcus is absent and buried underneath the temporal skin. Various surgical techniques have been reported for the correction of cryptotia following Kubo's V-Y plasty in 1933. Conventional methods using a local skin flap, skin grafting, tissue expansion, Z-plasty, and any of these combined approaches can result in skin deficiency of the upper auricle. The aim of this study was to develop a new method that improves cosmetic results and has fewer complications. Methods: This study involved four patients in whom five cryptotia deformities were corrected using V-Y plasty and Z-plasty. After elevation of the flap, acellular dermal matrix (ADM; MegaDerm) that was over 5 mm in thickness was applied to the cephalo-auricular angle and positioned to enhance the projection of the ear. Lastly, the flap was transposed to complete the repair. Results: Between January 2014 and February 2018, cryptotia correction with ADM graft was performed in four patients. None of the patients developed a recurrence of cryptotia, and there were no postoperative complications such as wound infection, seroma formation, and dehiscence. In addition, the procedures resulted in a favorable cosmetic appearance. Conclusion: Based on these findings, i.e., no recurrence and a favorable cosmetic result, when using an ADM graft, it is suggested that this technique could be an alternative method of cryptotia correction. It could also lessen donor-site morbidity when compared to autologous cartilage grafting and be more cost-effective than using cartilage from a cadaver.
The Journal of the Convergence on Culture Technology
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v.9
no.4
/
pp.537-542
/
2023
Recently, deformation of operating railway structures has occurred due to adjacent excavation works such as new structures and utility tunnel expansion concentrated around downtown areas. However, most of them are focused on structural review, repair and reinforcement of structures. A review of the Track is insufficient. In particular, in the case of the gravel track on the earthwork subgrade, the subgrade and the ballast are not solidified. A slight level of deformation can cause ballast relaxation. Sleeper support conditions may lead to unstable conditions. Sufficient safety must be ensured. In addition, it is a track type with a high risk of train derailment due to unstable support conditions. In this study, the correlation between the deformation characteristics of gravel tracks and track support performance according to subgrade deformation is experimentally and analytically verified. In addition, an evaluation technique that can evaluate the condition of the gravel track and the track support stiffness is presented.
Kim, Hyung-Tae;Sung, Si-Chan;Kim, Si-Ho;Chang, Yun-Hee;Ahn, Hyo-Yeong;Lee, Hyoung-Doo
Journal of Chest Surgery
/
v.44
no.2
/
pp.115-122
/
2011
Background: The intramural coronary artery has been known as a risk factor for early death after an arterial switch operation (ASO). We reviewed the morphological characteristics and evaluated the early and mid-term results of ASO for patients with an intramural coronary artery. Materials and Methods: From March 1994 to September 15th 2010, 158 patients underwent ASO at Dong-A and Pusan National University Hospitals for repair of transposition of the great arteries and double outlet right ventricle. Among these patients, 14 patients (8.9%) had an intramural coronary artery. Mean age at operation was $13.4{\pm}10.2$ days (4 to 39 days) and mean body weight was $3.48{\pm}0.33$ kg (2.88 to 3.88 kg). All patients except one were male. Eight patients had TGA/IVS and 4 patients had an aortic arch anomaly. Two patients (14.3%) had side-by-side great artery relation, of whom one had an intramural right coronary artery and the other had an intramural left anterior descending coronary artery. Twelve patients had anterior-posterior relation, all of whom had an intramural left coronary artery (LCA). The aortocoronary flap technique was used in coronary transfer in 8 patients, of whom one patient required a switch to the individual coronary button technique 2 days after operation because of myocardial ischemia. An individual coronary button implantation technique was adopted in 6, of whom 2 patients required left subclavian artery free graft to LCA during the same operation due to LCA injury during coronary button mobilization and LCA torsion. Results: There was 1 operative death (7.1%), which occurred in the first patient in our series. This patient underwent an aortocoronary flap procedure for coronary transfer combining aortic arch repair. Overall operative mortality for 144 patients without an intramural coronary artery was 13.2% (19/144). There was no statistical difference in operative mortality between the patients with and without an intramural coronary artery (p>0.1). There was no late death. The mean follow-up duration was $52.1{\pm}43.0$ months (0.5 to 132 months). One patient who had a subclavian artery free graft required LCA stenting 6.5 years after surgery for LCA anastomotic site stenosis. No other surviving patient needed any intervention for coronary problems. All patients had normal ventricular function at latest echocardiography and were in NYHA class 1. Conclusion: The arterial switch operation in Transposition of Great Arteries or Double Outlet Right Ventricle patients with intramural coronary can be performed with low mortality; however, there is a high incidence of intraoperative or postoperative coronary problems, which can be managed with conversion to the individual coronary button technique and a bypass procedure using a left subclavian free graft. Both aortocoronary flap and individual coronary button implantation techniques for coronary transfer have excellent mid-term results.
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